Organization Name: | EXCELTH, INCORPORATED |
NPI Number: | 1205275492 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BYRON TREGRE (CFO) |
Mailing Address: | 9900 Lake Forest Blvd Suite F New Orleans |
State: | LA US |
Postal Code: | 701272609 |
Phone Number: | 5045241210 |
Fax Number: | 5045241491 |
NPI Enumeration Date: | 06/20/2013 |
NPI Last Update Date: | 06/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |